How telemedicine can cut costs and speeds up care for pediatric orthopedic injuries

Kids are going to get bumps, bruises, sprains and broken bones. Often, parents first head to an urgent care center, which rarely have pediatric specialists on staff. Even pediatric urgent cares typically don’t have a practitioner trained to deal with musculoskeletal injuries. So, even though urgent care is often a parent’s first stop, it’s rarely their last, as many patients are taken, often by ambulance, to a pediatric trauma center.

A study from Nemours Children’s Health surveyed 350 pediatric orthopedic trauma patients who, due to the nature of their injuries, were transferred to pediatric hospitals from other local facilities, and found that more than a third of those transfers could have been avoided — meaning the patients would have gotten faster care at a much lower cost — through the use of telemedicine.

Alfred Atanda, MD, an orthopedic surgeon at Nemours who wrote the study, published in the Journal of the American Academy of Orthopaedic Surgeons, developed models to determine if and how the patient could have been treated differently if the urgent care provider and a pediatric orthopedic specialist had used a telemedicine consult. Some of those consultations could have ended with the patient being sent home with a recommendation to see a specialist the next day; whether the patient needed a costly ambulance ride or if a car ride would suffice; and allay concerns from the parents or caregivers.

“In most situations, a consultation between physicians, conducted via telemedicine, will cost less than automatically transferring the patient in an ambulance,” Atanda wrote. “With the rise of telemedicine and the ease of sharing medical images, triaging patients by moving information and knowledge could be more cost-effective than physically moving patients.”

The cost savings could also be substantial; the average cost for those patients who were transferred from urgent care to a new facility via ambulance was $6,610. If a telemedicine consult found that the child truly needed an ambulance ride, the cost was about the same. However, a telemedicine consult with no further action cost on average $120, and the average cost for all cases — including those patients who required a non-emergent follow-up appointment with a specialist — averaged $4,858.

“This research demonstrates how telemedicine can serve as a pathway to providing cost-effective, high-quality care in pediatric orthopedics,” Atanda said.